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Significant reduction in air pollution has occurred during the period of lockdown due to COVID-19 pandemic situation. It has given a wonderful opportunity to compare the air pollution as Industries and the maximum traffic of the city had been stopped during the lockdown, which otherwise could not be possible, to stop all the traffic and observe the impact. The study aims to compare the air pollution levels before and during the lockdown period in different areas of Pune city. The daily data of Air Quality Index, Sulphur di oxide and Oxides of Nitrogen is collected, compared, and analyzed. Analysis shows the fall in AQI in large extent which can be directly corelated with the traffic reduction in the city. The other factors like winter inversion, seasonal and festival effects are also considered for analysis. The data is also compared with previous year data for fair conclusions. The result shows the influence of anthropogenic sources of air pollution on AQI.

Background Most cases of peripheral pulmonary stenosis (PPS) associated with William's syndrome are usually very mild or resolve spontaneously. However, we encountered a paediatric case of William's syndrome (WS) with severe PPS. In this case, we investigate whether the patient's genetic background was responsible for the severity of the PPS. Case presentation Shortly after birth, the male patient was suspected as WS because of his peculiar facial appearance and PPS. Fluorescence in situ hybridization identified microdeletion in the 7q11.23 region, and he had a confirmed diagnosis of WS. PPS became worsened subsequently, and a cardiac catheterization was performed at the age of 7 years. Due to severe multiple PPS, the right ventricular pressure exceeded the left ventricular pressure. At the age of 12, he had haemoptysis, which required ventilatory management. A pseudoaneurysm of the right pulmonary artery was identified and a right middle lobectomy was performed. Methods and results First, we performed multiplex ligation-dependent probe amplification and whole exome sequencing, considering the possibility of homozygous mutations in the region responsible for WS (7q11.23) or a larger deletion of this region in the patient. The deletion was confirmed to be a heterozygous deletion with a typical range for WS. Therefore, we hypothesized that the causative gene of severe PPS may exist separately from the region responsible for WS. After reviewing the result of the whole exome sequencing, we identified a rare nonsense variant of the “X”-gene as the disease-causing gene. The X-gene is involved in the suppression of vascular smooth muscle cell proliferation and the generation of pulmonary arteriolar dilator “Y”. The X-gene has been reported as a disease-causing gene in patients with pulmonary arterial hypertension. Based on these previous reports, we assumed that the X gene variant could be a cause of PPS; therefore, we performed functional analysis. We first introduced a mutant X-gene construct into human pulmonary arterial endothelial cells (hPAECs) and human pulmonary arterial smooth muscle cells and found that the mutant significantly reduced the production of Y compared to the wild-type X-gene. When transfected into hPAECs, the mutant X gene significantly increased cell proliferation compared to the wild-type X-gene. The hPAECs also showed reduced caspase 3/7 activity and reduced apoptosis compared to wild-type X-gene transfected cells. In the patient's own lung pathology specimens, irregular fibrous thickening of the intima of the intrapulmonary arteries was observed, which supported the results of the functional analysis. Conclusion Our study showed that an X-gene variant could lead to reduced Y production in the pulmonary arteries, abnormal proliferation of hPAECs, and the development of severe PPS. As Y-replenishing drugs are already in clinical use, the results may lead to the development of medical treatments for severe PPS. Funding Acknowledgement Type of funding sources: None.

Injection-locking properties of a rotary travelling pulse developed in a system of tunnel-diode (TD) transmission lines are characterised for multiphase oscillation. The system includes a unique TD line loop coupled with evenly spaced straight TD lines. The oscillating voltage edges in straight lines are synchronised to organise the rotary pulse on the closed one. Based on the phase-reduction theory, the authors determine where to connect an external oscillator for sufficient locking frequency range. Inherently, the travelling pulse can rotate on the loop in either clockwise or anti-clockwise fashion. The rotation frequency slightly depends on the rotation direction by the finite fluctuation of device parameter values. By matching the frequency of the external oscillator with one of such frequencies, the rotation direction is specified as required. These injection-locking properties are validated experimentally.

The solid solutions of PbHf x Ti1 − x O3 were synthesized by the oxidant-peroxo method in the titanium rich region (x ≤ 0.5). Lattice parameters at room temperature were investigated as a function of x by means of powder X-ray diffraction and Rietveld analysis. The phase transition between the room-temperature tetragonal to the high-temperature cubic phase was studied by DSC and dielectric measurement. Phase transitions detected in both experiments were shifted to low temperatures and smeared with increasing x. The effects of Hf/Ti substitution on PbTiO3 were compared with those of Zr/Tifor samples prepared by the same way. It was clarified that the lattice constant c and the phase transition were more sensitive to Hf content than to Zr content.

Background: Inhalational anesthetics can cause profound hemodynamic effects including decreases in systemic vascular resistance and cardiac inotropy. Although widely used in uncontrolled hemorrhagic shock (UHS), their consequences compared with other anesthetic regimens are not well-studied. Ketamine-based total intravenous anesthesia (TIVA) may produce less profound cardiovascular depression, and has been used during elective surgery but rarely during traumatic shock. The purpose of this study was to compare the effects of isoflurane (ISO) and TIVA regimens in a swine grade V liver injury model. We hypothesized that TIVA would result in less hypotension and dysfunctional inflammation than ISO. Methods: Twenty swine were randomized blindly to receive either 1% to 3% ISO, or intravenous ketamine, midazolam, and buprenorphine for maintenance anesthesia. Six animals acted as controls. After sedation and intubation, randomized anesthesia was initiated and monitored by an independent animal technician. Invasive lines were placed followed by celiotomy and splenectomy. Baseline mean arterial pressure (MAP) was documented and a grade V liver injury created. After 30 minutes of UHS, animals were resuscitated with 8 mL of Ringer's lactate per milliliter blood loss at 165 mL/ min. MAP and tissue oxygen saturation (StO 2 ) were continuously recorded. The animals were sacrificed 120 minutes after injury and lung tissue was harvested. Serum cytokines (interleukin-6 [IL-6], IL-8, and tumor necrosis factor-a [TNF-a]) were quantified with enzyme-linked immunosorbent assay. Lung cytokine mRNA levels were quantified with real time reverse transcriptase polymerase chain reaction. Results: Animal weight, liver injury pattern, and blood loss were similar (p > 0.1). The ISO group had a lower MAP at baseline (p = 0.02), at injury (p = 0.004), and study completion (p = 0.001). After resuscitation, MAP decreased in the ISO group but remained stable in the TIVA group. StO 2 was significantly higher in the TIVA group immediately after injury (p = 0.004), but similar between groups throughout the remainder of the study. Animals who received TIVA trended toward higher levels of lactate and lower pH throughout the study, reaching significance at 30 minutes postinjury (p = 0.037 and 0.043). Inflammatory cytokine (IL-6, IL-8, and TNF-a) production did not differ between groups, however TNF-a mRNA production was significantly lower in the TIVA group (p = 0.04). Conclusion: Although a TIVA regimen produced less pronounced hypotension in a swine model of UHS than did ISO, end-organ perfusion with TIVA appeared to be equivalent or inferior to ISO. In circumstances of limited resources, such as those experienced by forward Army surgical teams, a ketamine-based TIVA regimen may be an option for use in UHS.

Objective— Angiogenesis plays a key role in the growth and function of normal and pathological tissues. We investigated the effect of pulsatile flow on endothelial cell (EC) in vitro angiogenic activity. Methods and Results— Bovine aortic ECs were exposed to “static” or “flow” (1.2 to 67.0 mL/min, shear stress 1.4 to 19.2 dyne/cm 2 ) conditions for 2 to 24 hours. After exposure, angiogenesis was measured as tubule formation on Matrigel, and EC migration was assessed by filter migration assay. Pulsatile flow increased angiogenesis and EC migration in a temporal and force-dependent manner, with a maximal effect at 16 hours (13.2 dyne/cm 2 ). Pertussis toxin completely inhibited the effect of pulsatile flow on angiogenesis and migration. Transfection of ECs with inhibitory mutants of the α subunit of G i 1 or G i 3, but not G i 2, inhibited the flow-induced angiogenic response by 61±2% and 32±6%, respectively, whereas transfection with constitutively activated mutants of the α subunit of G i 1 or G i 3, but not G i 2, increased the flow-induced response by 202±23% and 70±4%, respectively. In contrast, inhibition of Gβγ by the carboxy terminal fragment of β-adrenergic receptor kinase overexpression increased the flow-induced response by 82±8%. Conclusions— These results suggest that pulsatile flow stimulates angiogenesis and that this effect is mediated by activation of G iα 1 or G iα 3, but not Gβγ, subunits.

Large bowel obstruction is a common problem with many different causes, the most common being colorectal adenocarcinoma, extracolonic adenocarcinoma, diverticular disease, volvulus, and inflammatory bowel disease. The nature of the obstruction can influence the best management. Historically, treatment of obstruction consisted of surgical removal of the obstruction if possible and decompression of the bowel with an ostomy. Other strategies for managing obstruction have evolved as alternatives to stomas, including primary resection with anastomosis and endoscopic stent placement. The choice of treatment can therefore be tailored to the individual patient with good success.

We describe a case of partial molar change in a placenta that was associated with a normal female fetus who died in utero. The analysis of molar and normal placental tissue, as well as the karyotypic study of amnionic fluid indicate a complex origin of this conceptus. We review the possible mechanisms leading to this pregnancy and the general topic of partial hydatidiform mole. The formation of moles is complex and it is not easily divisible into so-called partial and complete hydatidiform moles. Rather, individual genetic study is needed to make an accurate diagnosis because macroscopic or microscopic examination alone fails to assess the complexity of these entities.

Editors' Note: Dr. Miyaji et al. and authors Sawai et al. debate moesin as a target molecule for CMV-related Guillain-Barre syndrome. Dr. Miyaji et al. were unable to validate the initial study, not identifying moesin antibodies in any of 41 patients with acute inflammatory demyelinating polyneuropathy (AIDP) using ELISA. The authors point out that the methodology differed from their study. Both groups agree that an animal model of AIDP through active immunization with moesin protein or passive transfer of immunoglobulin G antibodies is needed to confirm disease pathogenesis. —Megan Alcauskas, MD, and Robert C. Griggs, MD Sawai et al.1 reported moesin as a possible target molecule for cytomegalovirus (CMV)-related Guillain-Barre syndrome, especially acute inflammatory demyelinating polyneuropathy (AIDP). We aimed to validate their observations in our cohort of patients with AIDP by ELISA, which …

In a total-body irradiation (TBI), an absorbed dose of around 10 Gy is given to a patient with leukaemia within a couple of days. Delivery of a homogeneous dose throughout the whole body is difficult, and usually requires sophisticated irradation techniques. It is important to evaluate patient doses experimentally both for physical treatment planning and radiological protection. Organ and surface doses of patients were evaluated for a newly employed TBI technique - modified tracking technique. An experiment with a RANDO phantom demonstrated a good dose distribution over the whole body. Measurement of patient doses, however, revealed a variation of the doses between patients. Reproducibility of patient set-up is considered to be a critical factor for the variation, and improvement is desirable in this regard.

The sample and return mission to near Earth asteroid Nereus (4660) via an electric propulsion is presented in this paper, which is investigated at the Institute of Space and Astronautical Science (ISAS). An ion thruster is assumed here for Solar Electric Propulsion (SEP), which enables even the smallest spacecraft that weighs about only 350 kg to accomplish that difficult mission. ISAS is scheduling to launch one Lunar and one Martian orbiter in 1997 and 1998 via its own transporter M-V. And this concept follows them next in the launch window of 2002. The approach and exploration scenario to Nereus are also described here in detail, among which the mapping as well as sampling sequences are focused on. Especially, the sampling scheme proposed here is the characteristic point featuring an ‘artificial landmark’, which is the target plate dropped on the surface. This is used for the spacecraft to make a rendezvous autonomously with it via an optical aid onboard. Samples are assumed to be recovered via a hyperbolic reentry capsule on the ground. Practical weight estimation based on some heritages of ISAS does firm the spacecraft design feasibility.

This paper overviews recent attempts at co-integrating nano-electro-mechanical systems (NEMS) with nanoelectronic devices aiming to add more functionalities to conventional Si devices in ‘More-than-Moore’ domain and also explore novel physical principles in ‘Beyond CMOS’ domain.

In this paper we overview recent attempts at co-integrating silicon nano-electro-mechanical systems (NEMS) with nanoelectronic devices aiming to add more functionalities to conventional electronic devices in ‘More-than-Moore’ domain and also explore novel operating principles in ‘Beyond CMOS’ domain.

Adsorption of bovine serum albumin (BSA) on calcium hydroxylapatite (HAP) with different Ca/P molar ratios ranging from 1.55 to 1.70 and on HAP surface-modified by silicate and fluoride ions has been studied at pH 6.0 and 288 K. The adsorption isotherms of BSA on HAP particles are of the Langmuir type and adsorption of BSA generated a negative charge on HAP. Unmodified HAP particles which have a larger Ca/P molar ratio tended to yield a larger electrically positive zeta potential, which in turn gave a larger saturated amount of adsorbed BSA ( n s ) as a result of their electrostatic attractive force. The surface modification by silicate ions increased the surface acidity and made the HAP surface more electrically negative so as to yield smaller n s values. On the contrary, surface modification by fluoride ions increased n s two-fold over that on the unmodified surface. This fact could be explained by the formation of highly basic CaF 2 on the HAP surface.

The effect of plutonium isotopic composition and of 241Am on MOX fuel burn-up and the worth of each plutonium isotope in the ATR (Heavy-Water-Moderated, Boiling-Light-Water-Cooled Type) was analyzed using the WIMS-ATR code, the library data of which were validated by Fugen operation data, results of PIE (Post Irradiation Examination) of Fugen MOX fuel and critical experiments in DCA (Deuterium Critical Assembly). The MOX fuel burn-up is slightly affected (1 ∼ 2%) in ATR by the plutonium isotopic composition the (239Pu+241Pu)/total Pu ratio of which is in the range of ∼64% to ∼70%. In the ATR, the worth of each plutonium isotope depends somewhat on the plutonium isotopic composition, burn-up and the number of fuel pins in the fuel assembly.

Ab initio simulation of 'nanophonons' has been conducted for the first time for the H-terminated ultrathin Si films of 3 to 10 atomic layers in thickness and have revealed that the phonon bandgaps are formed as a result of the Si dimers on the surface.

Recent clinical studies have shown a sex dimorphism of morbidity and mortality due to shock, trauma, and sepsis, with females tolerating these insults better than males. Experimental animal studies have suggested that sex hormones have a pivotal role in this dimorphism. In the present investigation, a prospective cohort study at a university level-1 trauma center was conducted to evaluate the association between sex hormones and alterations in coagulation and inflammation. Patients with an admission to the intensive care unit, injury severity score (ISS) greater than 4, and obtainable consent were included in the study. In addition to routine clinical laboratories and patient outcomes, plasma TNF-[alpha], IL-6, IL-8, estradiol, progesterone, and testosterone were measured. Sixty-two patients (71% men, 29% women) met criteria for entry. Mean age was 42 +/- 17 years, and mean ISS was 23 +/- 13, with no statistical difference in age or ISS between sexes. Estradiol levels were positively correlated with ISS (P < 0.05) and negatively correlated with TNF-[alpha] (P < 0.01). Initial estradiol levels were higher in patients who developed an infection (P < 0.05). Testosterone was negatively correlated with age (P < 0.01) and was higher in patients who developed acute respiratory distress syndrome (P < 0.05) and in patients who did not survive (P < 0.05). The estradiol-to-progesterone ratio (E2-Pr) was higher in the survivors (P < 0.05). The E2-Pr had positive correlations with fibrinogen levels, rate of fibrin deposition and cross-linking, and overall clot strength (P < 0.05). Estradiol-to-progesterone ratio was negatively correlated with partial thromboplastin times (P < 0.01). In men, the E2-Pr was also negatively correlated with the time to onset of clot formation (P = 0.03). Sex hormone levels (or their ratios) were not correlated to platelet count or international normalized ratios. These findings provide evidence that sex hormone levels in the early posttraumatic period are significantly associated with alterations in the hemostatic and inflammatory response to trauma.

Joyo, the 100 MW t experimental reactor, has been successfully operated since 1977, and Monju, the 280 MW e prototype FBR, is under construction, with the first criticality planned for 1992. To promote FBR R&D efficiently — including the demonstration FBR (DFBR) programme — a steering committee for R&D was organized in 1986 by the Japan Atomic Power Company, the Power Reactor and Nuclear Fuel Development Corporation, the Japan Atomic Energy Research Institute and the Central Research Institute of Electric Power Industry. A design study of the DFBR is now underway to define its basic specifications by 1990. R&D for Monju, DFBR and future commercial FBRS has been done (1) to improve key technologies developed through the Joyo and Monju programmes; (2) to develop innovative technologies to make FBRS commercial; (3) to promote FBR development in conjunction with the development of the FBR fuel cycle.

Field-reversed configuration (FRC) plasmas are governed by the nonlinear Grad-Shafranov equation and it is difficult to analyze this equation for FRC devices by using domain-type methods because the plasma boundary is a free boundary. In the present work, the authors solve the Grad-Shafranov equation using the boundary element method (BEM) in order to study equilibrium configurations for the FRC with a free boundary. In the numerical analysis, the simple iterative method is used to obtain nonlinear solutions of the equation. As a result it is found that a stable solution can only exist for parameter K, which denotes the ratio of the electromagnetic force to the plasma pressure. In addition, the equilibrium configuration is calculated by using BEM for the rigid drift model and the slitted model. >

Specific heat capacity measurement was performed for a disk-shaped specimen by means of a technique of thermal radiation calorimetry. The specimen whose surfaces are blackened is heated by double flat heaters in a vacuum chamber. The heat capacity is derived only by measurement of the specimen temperature and the heater temperature on both heating and cooling modes. The simultaneous measurement of heat capacity and dielectric constant associated with phase transition was performed for advanced ceramics.

In this paper, a surface recovery method using multiresolution wavelet transform is proposed. For representing 3-D surface shapes, 4th order B-spline functions are introduced as scaling functions of spline wavelets. A regularization problem is solved in order to estimate the surface function. The estimated surface function can be decomposed into an approximate surface function at specific lower resolution and the corresponding wavelet components by using the multiresolution wavelet transform. Consequently, by reducing the noise components which the wavelet components include, the surface recovery method can give a further accurate estimation of the surface function. Through several experiments, both the robustness to noises and the edge-preserving property in recovering the surface have been attained.

Fine perylene and pyrene particles were produced by evaporation in helium gas. The particles were sensitive to electron beam radiation. The pyrene particles sublimed under observation. These difficulties were cleared up by reducing electron beam exposure and sandwiching a specimen between two Formvar films. The fine perylene particles were rectangular or hexagonal plates about 50nm thick. The size was about 200-2000nm. The fine pyrene particles were polymorphic with a size of about 300-2000nm. The crystal forms of the perylene and pyrene particles were determined from the electron diffraction patterns to be alpha-perylene and pyrene I, respectively.

We describe a case of partial molar change in a placenta that was associated with a normal female fetus who died in utero. The analysis of molar and normal placental tissue, as well as the karyotypic study of amnionic fluid indicate a complex origin of this conceptus. We review the possible mechanisms leading to this pregnancy and the general topic of partial hydatidiform mole. The formation of moles is complex and it is not easily divisible into so-called partial and complete hydatidiform moles. Rather, individual genetic study is needed to make an accurate diagnosis because macroscopic or microscopic examination alone fails to assess the complexity of these entities.

A 73-year-old man was hospitalized because of weight loss and fever. Laboratory data showed marked leukocytosis (21,200/mm3), granulocytosis (89.7%), thrombocytosis (47.8 x 10(4)/mm3), increased CRP (15.8 mg/dl), and increased SCC (5.0 ng/ml). Chest X-ray films demonstrated a mass shadow in the right upper lung field. Chest computed tomographic scans revealed a mass shadow 58 mm in diameter with mediastinal pleural invasion in the right S1. Right upper lobectomy and dissection of regional lymph nodes was performed under a diagnosis of lung cancer (squamous cell carcinoma, T3 N0 M0 stage IIB) with concomitant infection. Serum G-CSF was 234 pg/ml pre-operatively and 68.8 pg/ml postoperatively. The cytoplasm of tumor cells stained positively with anti-recombinant human G-CSF monoclonal antibody. No general bacteria or mycobacteria were detected within the specimen. Postoperatively, the patient's white blood cell count, platelet count, and CRP level soon decreased, and the fever disappeared. We diagnosed the disease as G-CSF-producing squamous cell type lung cancer.

Indications for surgical treatment in advanced lung cancer still remain to be established.The outcomes of combined resection of adjacent organs in lung cancer were assessed in terms of complications and the invasiveness of surgery, using intraoperative blood loss and operation time as indices.In 68 patients undergoing combined resection between 1980 and 1997, the 5-year-survival rates and the incidence of complications and hospital deaths were 24.5%, 52.9%,and 10.3%, respectively. The mean blood loss and operation time were 1,200 ml and 396 minutes. The rares of complications and hospital deaths were significantly higher in the group with 1,000 ml or more blood loss, and in the group with 360 minutes or longer operation time.In terms of the survival rate, invasiveness of surgery, and complications, the pleura and pericardium were the best indications for combined surgery. For the thoracic wall, blood loss was greater and the rates of complications and hospital deaths tended to be higher among T3 cases. Both blood loss and operation time tended to be greater in T4 cases. Indications for surgery need to be carefully determined with respect to curability.

The aim of the present study was to compare the safety of endoscopic variceal ligation (EVL) and endoscopic injection sclerotherapy (EIS) in terms of liver and kidney functions in patients with liver cirrhosis.Forty-four patients admitted to Takatsuki General Hospital between February 1991 and March 1993 with esophageal varices due to liver cirrhosis were randomly assigned to receive either EVL or EIS. Serum levels of AST, ALT, total bilirubin (T-bil), direct bilirubin (D-bil), prothrombin time (PT), hepaplastin test (HPT), antithrombin III (ATIII), creatinine (Cr), and blood urea nitrogen (BUN) were measured before and 24 h, 3 days, 7 days, and 14 days after both forms of therapy.Significant elevations of serum T-bil, serum D-bil, and serum ALT and AST levels were observed in the EIS group but not in the EVL group. No significant increases of serum PT, HPT, ATIII, BUN, or Cr levels were observed after treatment in either group.EVL should be considered a first choice therapy for eradicating esophageal varices.

The c-myc and p53 genes are thought to be an oncogene and a tumor suppressor gene, respectively. These genes' products are characteristic of malignant tumors. We quantitatively analyzed the c-myc and p53 products by flow cytometry in two cases of pulmonary sclerosing hemangioma. In case 1, 32.3% of the tumor cells were found to have the c-myc product, and 8.9% were found to have the p53 product. In case 2, 6.7% of the tumor cells were found to have the c-myc product and 15.5% were found to have the p53 product. The percentages in both cases were twice as high as those in a negative control lymphocytes stained with c-myc and p53 products. Therefore, these two cases showed positive expression of the c-myc and p53 products. In addition DNA from six other patients with sclerosing hemangioma was analyzed with paraffin-embedded sections. All six had DNA diploidy, with DNA indexes ranging from 0.91 to 1.03 and coefficients of variation ranging from 3.0 to 5.5. We suggest that pulmonary sclerosing hemangioma is a very weakly malignant tumor.

E-cadherin (E-CD) expression and its clinicopathological implication were investigated in 26 patients with breast cancer by immunohistochemical staining. 12 out of 26 primary lesions (46%) express strong and homogeneous expression of E-cadherin (preserved type), while in 14 cases (54%), degree of E-CD expression was reduced, i.e., 8 patients with heterogeneous staining, 2 cases with weak but homogeneous, and 4 cases with lost expression of E-CD (reduced type). However, there was no statistically significant correlation among decrease of E-CD expression, histological features, and advanced stages of breast cancer. Analysis on survivals showed better prognosis in the group with preserved E-CD expression than without E-CD (follow up was more than 96 months or until death). These findings suggests that the patients with decreased E-CD expression may be associated with metastasis resulting in poor prognosis, and E-CD expression could be one of the prognostic factors.

We examined replication error (RER) and loss of heterozygosity (LOH) in the region of microsatellites in 60 cases of resected lung cancer. We used microsatellite probes for the short arm of the 2nd chromosome (D2S123, D2S136), the short arm of the 3rd chromosome (D3S1067), and the short arm of the 17th chromosome (TP53). According to stage, the frequency of LOH was 25% in stage I, 33% in stage II, 44% in stage IIIA, 11% in stage III B, and 63% in stage IV. According to histological classification, the frequency of LOH was 41% for squamous cell carcinoma, 24% for adenocarcinoma, and 100% for small cell carcinoma. According to microsatellite probe results, the frequency of LOH was 6.7% for D2S123, 5.0% for D2S136, 16.7% for D3S1067, and 18.3% for TP53. Two of the 60 cases showed RER. One case was stage I squamous cell carcinoma, and the other was stage IV adenocarcinoma. Except for stage III B,LOH in the microsatellite region increases with the stage. LOH is often detected in the order of small cell carcinoma, squamous cell carcinoma, and adenocarcinoma. According to the chromosome number, LOH is detected more often in the 3rd and 17th chromosomes than in the 2nd chromosome. In 20 cases with LOH, only two showed DNA diploidy. Compared to LOH of the microsatellite region, DNA content analysis by flow cytometry has accuracy problems.

Twenty four patients with recurrent or multiple lung cancer were reoperated in our center. Five-year survival rate was 20% for 11 patients with recurrent, while was 25% for 13 patients with multiple after reoperation. The patients with limited operation had well survival and there was no significant difference in procedure. However all four patients with N2 had poor prognosis. Seven patients (29%) had the post reoperative complication in pulmonary system. All of them had the impairment of pulmonary function (FEV1.0% was less than 50%) or more than 75% perfusion ratio, measured with pulmonary perfusion scintigraphy, in the side of the reoperation.

We quantitatively analyzed the c-myc and p53 products using flow cytometry in 28 cases of resected lung cancer and one case each of chorio-carcinoma, plasmacytoma, malignant mesothelioma and sclerosing hemangioma. In the lung cancer cases, c-myc and p53 products were detected in 10 cases (35%) and 7 cases (21%), respectively. These rates are higher than the DNA abnormal expression rates of the c-myc and p53 genes (15% and 12%, respectively) in our own data. In the adenocarcinoma of lung cancer cases, c-myc and p53 products were detected in 9 cases (53%) and 5 cases (29%), respectively. Among the squamous cell carcinoma cases, there were one case (11%) of c-myc expression and one case (11%) of p53 expression. DNA content analysis of the lung cancer patients revealed 7 cases of DNA diploidy and 21 cases of DNA aneuploidy. All 10 c-myc-positive cases showed DNA aneuploidy; thus the positive rate for c-myc products in the DNA aneuploidy cases was significantly different compared with the DNA diploidy cases (p0.05). In the sclerosing hemangioma case, we detected both c-myc and p53 products. Sclerosing hemangioma has been thought to be a benign tumor, but it may be a malignant tumor.

Between 1975 and 1992, mediastinoscopy and thoracotomy were performed on 184 T1 and 271 T2 lung cancer cases consisting of adenocarcinoma and squamous cell carcinoma. Mediastinoscopy gave true negative findings in 90.8% of the T1 patients, true positive findings in 7.6% and false negative findings in 1.6%. The comparable rates were 76.7%, 17.0% and 6.3% in T2 patients. The 5-year survival rate was 91.3% for T1N0M0 patients (n = 64) who underwent non-radical dissection (= NRD), and 69.4% for those (n = 70) who underwent radical dissection (= RD). The rate with NRD was significantly better (p0.006). The 5-year survival rate was 63.2% for T2N0M0 patients (n = 62) undergoing NRD, and 49.8% for those (n = 72) undergoing RD, but the difference was not significantly. Distant metastasis was a common cause of death, whereas there were no deaths due to local recurrence in the T1N0M0 patients, whether NRD or RD was performed. These results support our opinions that preoperative mediastinoscopy and intraoperative node staging are sufficient for assessment of the N factor in T1 and T2 lung cancer, and that mediastinal node dissection should not be performed in T1N0M0 patients.

Mitoxantrone (MIT) is a new anthraquinone anti-cancer agent. We successfully treated 3 patients with locally advanced breast cancer, including two inflammatory breast cancers, by pre-operative arterial injection of MIT. The treatment protocol was MIT 12 mg/m2 injected into both the internal mammary and the subclavian artery with oral administration of 5' DFUR 1,200 mg/day. In two cases of inflammatory breast cancer, the redness of skin was immediately reduced after the first course. After 2 courses, all tumors were decreased over 50% in size. Standard radical mastectomy could be carried out on all patients. Preoperative arterial injection of MIT might be the treatment of choice for locally advanced breast cancer. This preliminary result encourages further study.

We experienced a patient with two peaks of elevated monoclonal IgM and IgA in the serum, and lambda type Bence-Jones protein in the urine. Chest X-ray films showed right pulmonary infiltrative shadow and effusion. The results of the autopsy of this patient revealed infiltration of malignant lymphoma cells in both lungs, but in no other organs. The results of immunohistochemical staining for L26. UCHL-1, IgM, IgA and lambda chain in this case led to the diagnosis of diffuse small cell type. B-cell lambda, IgM type malignant lymphoma. Gene analysis using bone marrow did not reveal any rearrangement bands for the heavy chain, light chain kappa and lambda, or TcR beta genes. Therefore, we concluded that malignant lymphoma cells had infiltrated only the bilateral lungs, causing a rare case of primary pulmonary malignant lymphoma with two monoclonal peaks of increased serum IgM and IgA.

DNA content analysis using flow cytometry and amplification of c-myc, L-myc, and c-erbB-2 oncogenes in 143 cases of resected lung cancer were analyzed using the same specimen, and we examined the correlation with prognosis of DNA content and amplification of oncogenes. There were 54 DNA diploid cases (38%), 81 DNA aneuploid cases (57%) and 8 DNA multiploid cases. Analysis of oncogene amplification revealed 22 cases of c-myc, 4 cases of L-myc, and 22 cases of c-erbB-2. In curatively resected cases, the 5-year survival rate was 65% in 31 DNA diploid cases, and 36% in 40 DNA aneuploid cases. There was a statistically significant difference between the two groups (p0.02). However, in non-curatively resected cases, the 5-year survival rate was 11% in 23 DNA diploid cases, and 33% in 49 DNA aneuploid cases. There were no statistically significant differences among these groups. The correlation between DNA content and amplification of oncogenes was as follows. In DNA diploid cases, there were 4 cases of c-myc, and 6 cases of c-erbB-2. In DNA aneuploid cases, there were 15 cases of c-myc, 4 cases of L-myc, and 15 cases of c-erbB-2. In DNA multiploid cases, there were 3 cases of c-myc, and 1 cases of c-erbB-2. Amplification of oncogenes was seen more frequently in DNA aneuploid and multiploid cases than in DNA diploid cases. In 71 curative resected cases, the 5-year survival rate for amplified cases of c-myc (10 cases) was 0%, and that of cases with no amplification was 61% (no statistically significant difference). The 5-year survival rate for amplified cases of c-erbB-2 (10 cases) was 40%, against 52% for cases with no amplification. DNA content analysis using flow cytometry was more convenient than analysis of amplification of oncogenes, and reflects the prognosis of resected lung cancer better than oncogenes. There was no relation between DNA content and gene amplification.

Of 140 cases of mediastinal neoplasms in our hospital, histological diagnosis was confirmed in 129 cases. We examined the methods of preoperative biopsy with those 129 cases. Biopsy had been performed in 25 cases. Mediastinoscopy was performed in seven cases, needle biopsy in eight cases, lymph node biopsy in eight cases, esophageal biopsy using a gastrofiberscope in one case, transbronchial biopsy using a bronchoscope in one case. The true positive rates of those methods were 100% for both mediastinoscopy and lymph node biopsy, and 75% for needle biopsy. Preoperative misdiagnosis occurred in two cases of needle biopsy. The postoperative histological diagnosis was malignant lymphoma in both cases. We performed gene analysis of the immunoglobulin heavy chain gene, light chain kappa and lambda genes, and the T-cell receptor beta gene by use of biopsied specimens, and we found rearrangement bands of these genes in the cases of malignant lymphoma. Therefore, we summarize that gene analysis is a reliable method if malignant lymphoma is suspected. If a needle biopsy is performed under CT guidance, the needle is sure to puncture the tumor. We concluded, therefore, that if a tumor is located in the anterior mediastinum, CT-guided needle biopsy should be performed first of all. Mediastinoscopy is a useful method if the tumor is located in the mid-mediastinum.

A case of leiomyosarcoma of the esophagus was reported. The tumor was located in the lower esophagus. The esophagus was very stenotic, but the mucosa was clear. We thought the tumor had not invaded the mucosa. Enucleation was performed on the tumor. The tumor was encapsulated, so at the time of operation, the microscopic diagnosis was leiomyoma. However, after the operation, the diagnosis was changed to the leiomyosarcoma, because there are many spindle-shaped atypical cells, and many mitoses. We also analyzed the DNA content of the tumor. The DNA index of this tumor was 0.9 and 1.48, therefore, this tumor was DNA aneuploidy. The result of DNA content analysis showed that the tumor is malignant. DNA content analysis is helpful for diagnosis of this kind of sarcoma, because microscopic examination can not readily distinguish benign leiomyoma from malignant leiomyosarcoma. This patient was still alive one year after the operation. Thus, we thought that enucleation of the tumor is a good operational procedure to the leiomyosarcoma of the esophagus, if the tumor is polypoid type and encapsulated.

A 23-year-old female was admitted to our hospital because of a mediastinal tumor. She complained of primary amenorrhea, and abdominal echosonography was therefore performed, revealing the absence of a uterus. Chromosome analysis revealed a 46 XY genotype, indicating the patient to be a male, not a female. Left renal venography demonstrated residual blood vessels originating in the Mullerian ducts. Thoracotomy and laparotomy were performed, and the mediastinal tumor and bilateral testes were resected. Postoperative pathology revealed that the mediastinal tumor was a neurinoma. There was no spermatogenesis, but hyperplasia of Sertoli cells in the testes was seen. Neither the neurinoma nor the testes were malignant. Bioassay of the testes showed no androgen receptors, leading to the diagnosis of testicular feminization syndrome with the complete form of androgen insensitivity. There have been many reports of an association between testicular feminization syndrome and malignant tumors of the testes, but few reports of an association between testicular feminization syndrome and benign tumors such as neurinoma. Accordingly, the present case was considered to be unusual and worth reporting.

We present a case of 43-year-old man with pure red cell aplasia appearing 8 years after thymothymectomy. He underwent an operation and postoperative radiotherapy for malignant thymoma associated with myasthenia gravis in 1983. In 1991 high serum level of SCC antigen was noted and a metastatic tumor was found in the retroperitoneal region. After removal of the tumor pure red cell aplasia developed, which responded to steroid therapy. The serum level of SCC antigen is still abnormally high.

On etudie le comportement d'une poudre de diamant synthetisee par choc sous des conditions statiques de pression et temperature elevees (7,7 GPa et 2273 K), et on le compare au comportement de poudres de diamant preparees sous differentes conditions statiques.